Supplier Registration

If you're interested in becoming a Grange supplier, please complete and submit this form.

FEIN

Company Legal Name

DBA

First Name

Last Name

Title

Phone

Email

Service Information

Briefly describe the products and/or services you're offering:

Supplier diversity

Grange Insurance is committed to working to strengthen its support of and business transaction with diverse suppliers. Grange defines a diverse supplier as a business enterprise that is at least 51% owned, operated and controlled by a minority, woman, veteran or LGBT and certified as such by one of the following organizations:

• National Minority Supplier Development Council (NMSDC) or regional affiliates
• Women's Business Enterprise National Council (WBENC) or regional affiliates
• National Veteran-Owned Business Association (NaVOBA)
• National Gay, Lesbian Chamber of Commerce (NGLCC) or regional affiliates

Based on this description, do you believe that you qualify as a diverse supplier?
Yes
No


Please indicate which organizations, if any, have certified your business. (optional)
National Minority Supplier Development Council (includes regional affiliates)
Women's Business Enterprise National Council (includes regional affiliates)
National Veteran-Owned Business Association (NaVOBA)
National Gay, Lesbian Chamber of Commerce (includes regional affiliates)